Individual
DR. DEREK JAY BAUME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
12337 HANCOCK ST 20, CARMEL, IN 46032-5885
(317) 706-6744
(317) 706-6700
Mailing address
12337 HANCOCK ST 20, CARMEL, IN 46032-5885
(317) 706-6744
(317) 706-6700
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20042084A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201163980
—
IN
05
—
201178980A
—
IN
01
—
IN1231
MEDICARE GROUP
IN
01
—
IN1231001
MEDICARE PTAN
IN
Enumeration date
01/01/2007
Last updated
11/26/2015
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